Exploratory Analysis Research Articles

Centralized climate clubs and decentralized governance: A model of global CO2 mitigation

AbstractThis paper extends the climate literature by examining the feasibility of integrating sub‐national governance into global club governance for mitigating CO2 emissions. Global climate clubs become an argument for having separate bundles of emission targets and incentive mechanisms in the form of opportunities for climate finance and technology sharing among the club members. An exploratory analysis is important to examine the role of import and export taxes and other channels, such as the clean development mechanism, in meeting the objective of nonmember countries to join the club. The crux, however, is how, after determining national‐level quotas, the mitigation responsibilities are shared with subnational entities. We propose a design of a carbon entry tax at the subnational level, namely states, districts, and municipalities. The carbon entry tax uses the nighttime luminosity data published by NASA as a measure of carbon, which constitutes the tax base. The carbon entry tax serves as a fiscal instrument of decarbonization in a decentralized framework.

The Development and Validation of a Tool to Evaluate the Determinants of Iron-Rich Food Intake among Adolescent Girls of Senegal

To reduce anemia among adolescent girls, factors that influence the consumption of iron-rich foods/IRF have not been investigated, and neither has a tool been developed to assess its determinants. Using the extended version of the theory of planned behaviour/eTPB, this study aims to develop and validate a questionnaire assessing individual and environmental factors that could influence IRF intake among Senegalese adolescent girls aged 10–19 years old. First, eight focus group discussions (FGDs) were held in different regions to identify salient beliefs related to each of the four constructs of the eTPB. Information from FGDs was used to develop a questionnaire that was administered to the first group (n = 200) of girls. Principal component and exploratory factorial analyses were then performed to identify latent factors for each construct. A modified version of the tool was administered to the second sample of girls (n = 400), and confirmatory factorial analyses were conducted. Hancock and Muller’s H reliability index was computed on the final model. Most metrics for fit indices were respected, and the H value was satisfactory. This study proposes a tool that could be used to explore determinants of the consumption of IRF among adolescent girls.

Globally, songs and instrumental melodies are slower and higher and use more stable pitches than speech: A Registered Report.

Both music and language are found in all known human societies, yet no studies have compared similarities and differences between song, speech, and instrumental music on a global scale. In this Registered Report, we analyzed two global datasets: (i) 300 annotated audio recordings representing matched sets of traditional songs, recited lyrics, conversational speech, and instrumental melodies from our 75 coauthors speaking 55 languages; and (ii) 418 previously published adult-directed song and speech recordings from 209 individuals speaking 16 languages. Of our six preregistered predictions, five were strongly supported: Relative to speech, songs use (i) higher pitch, (ii) slower temporal rate, and (iii) more stable pitches, while both songs and speech used similar (iv) pitch interval size and (v) timbral brightness. Exploratory analyses suggest that features vary along a "musi-linguistic" continuum when including instrumental melodies and recited lyrics. Our study provides strong empirical evidence of cross-cultural regularities in music and speech.

Abstract B007: Urinary cytokine profiles reflect rationale for treatment with gemcitabine and Bacillus Calmette-Guérin (BCG) in BCG-exposed high-risk non-muscle invasive bladder cancer (NMIBC)

Abstract Background: Bacillus Calmette-Guérin (BCG) remains the most efficacious and widely studied intravesical therapy for NMIBC, but less than 50% of BCG-exposed patients will respond to a second course of BCG. One mechanism of resistance to BCG is an immunosuppressive tumor microenvironment with myeloid-derived suppressor cells (MDSCs), tumor associated macrophages (TAMs), and Tregs that abrogate the anti-tumor immune response. IL-6 is associated with MDSCs and BCG resistance. Gemcitabine (Gem), however, has been shown to selectively inhibit MDSCs, TAMs, and Tregs. This observation served as the biologic rationale for our recently completed Phase I trial of combination chemoimmunotherapy with intravesical Gem and BCG for BCG-exposed high-grade (HG) NMIBC (NCT04179162) that demonstrated excellent tolerability and preliminary efficacy (96% complete response at 6-month follow-up). We sought to evaluate immune modulation with the addition of Gem to BCG as determined by changes in urinary cytokine/chemokine levels. Methods: Patients with BCG-exposed papillary HG NMIBC (Ta/T1) +/- carcinoma in situ recurring within 24 months of BCG therapy were treated with intravesical Gem twice weekly (weeks 1,4,7,10; 8 total doses) and intravesical TICE BCG weekly (weeks 2,3,5,6,8,9; 6 total doses) followed by SWOG maintenance BCG for responders. Urine specimens were collected prior to treatment and on weeks 4, 8, 12, 24, and 52 weeks after on-trial treatment initiation. Urinary cytokines present in the supernatant were evaluated using a 96-plex immuno-oncology proximity extension assay (Olink®). Cytokines with < 75% of values below the lower limit of detection of the assay were not evaluated. We performed an exploratory analysis of select pre-specified cytokines using a linear mixed model. Mean changes and 95% confidence intervals (CI) are presented with global p-values testing for a change in cytokine levels at any timepoint. Results: Urine samples were available for all 25 patients in the Phase I study. A total of 25 proteins on the panel were excluded due to low detection. Chemokines associated with T-cell trafficking (CXCL9, CXCL10, CXCL11) increased during induction treatment through 3 months of follow up and then returned to baseline after the completion of treatment (p<0.001 for each cytokine). IL-6 decreased after initiation of treatment and remained low through 12 months of follow up (-2.7, 95% CI -3.8, -1.7; p<0.001). Notably, the one patient who had a recurrence also had a rise in IL-6 after an initial decline while on treatment. Conclusion: We found evidence that the addition of intravesical gemcitabine to BCG favorably augments the tumor microenvironment based on changes in urinary cytokine/chemokine profiles. Additional tumor and urinary correlatives are ongoing. Based on the the robust preliminary efficacy demonstrated in the ongoing phase I/II trial (NCT04179162), a prospective randomized controlled trial comparing GemBCG to BCG alone for BCG-exposed NMIBC is planned through the National Clinical Trial Network (Alliance A032303). Citation Format: Christopher D. Gaffney, Syed M. Alam, Jessica A. Lavery, Merve Basar, Neeta D'Souza, Christian Hernandez, Melissa McCarter, Patricia Moran, Kristen Stasi, Kara Worth, Daniel Sjoberg, Guido Dalbagni, Timothy Donahue, Sherri Donat, Dean Bajorin, Bernard H. Bochner, Alvin Goh, Judy Sarungbam, Hikmat Al-Ahmadie, Eugene J. Pietzak. Urinary cytokine profiles reflect rationale for treatment with gemcitabine and Bacillus Calmette-Guérin (BCG) in BCG-exposed high-risk non-muscle invasive bladder cancer (NMIBC) [abstract]. In: Proceedings of the AACR Special Conference on Bladder Cancer: Transforming the Field; 2024 May 17-20; Charlotte, NC. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(10_Suppl):Abstract nr B007.

Is the GI Bill Enough? An Exploratory Analysis of Student Veteran Borrowing in College

In the United States, many student veterans use their GI Bill benefits to help fund their postsecondary education; however, when the GI Bill is not enough, student veterans may turn to grants and loans to subsidize their financial needs. This study examines the degree and extent to which Pell Grants and student loans are being used by student veterans using data pulled from the National Center for Education Statistics’ Baccalaureate and Beyond dataset. We found that Pell Grant awards were higher for student veterans with disabilities as well as Blacks and that a student’s age contributed to the overall amount of federal student loans borrowed. Implications, future directions, and a discussion of the results are provided.

Can Digital Skills Empower Disadvantaged Castes and Women? Evidence From India

How do digital skills influence individuals’ wages in contexts where caste-based and gender-based social stratification play an important role? We draw on sociology and economics literature to argue that the returns to digital skills in such contexts are shaped by caste and gender, and that digital skills empower disadvantaged individuals to increase their wages. Our empirical analysis of a rich micro-dataset on more than 20,000 individuals across all states in India from two waves of Indian Human Development Survey in 2005 and 2011 yields two key findings. First, we find that the positive returns to digital skills are greater for individuals from the Scheduled Castes and Scheduled Tribes in India than for individuals from other castes. Second, we find that the returns to digital skills are greater for women than for men. We also find that movement up the skilled occupation ladder is a mechanism that mediates the relationship between digital skills and wages. Our post hoc exploratory analyses suggest that among individuals from the lowest castes (Scheduled Castes and Scheduled Tribes), the returns to digital skills are greater for women than for men, and that returns to digital skills are lower in regions with less developed infrastructure and lower literacy rates than in other regions. We discuss the implications of our findings for diversity, equity, and inclusion research in operations management.

Exploratory biomarker analysis in the phase III L-MOCA study of olaparib maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer.

The prospective phase III multi-centre L-MOCA trial (NCT03534453) has demonstrated the encouraging efficacy and manageable safety profile of olaparib maintenance therapy in the Asian (mainly Chinese) patients with platinum-sensitive relapsed ovarian cancer (PSROC). In this study, we report the preplanned exploratory biomarker analysis of the L-MOCA trial, which investigated the effects of homologous recombination deficiency (HRD) and programmed cell death ligand 1 (PD-L1) expression on olaparib efficacy. HRD status was determined using the ACTHRD assay, an enrichment-based targeted next-generation sequencing assay. PD-L1 expression was assessed by SP263 immunohistochemistry assay. PD-L1 expression positivity was defined by the PD-L1 expression on ≥ 1% of immune cells. Kaplan-Meier method was utilised to analyse progression-free survival (PFS). This exploratory biomarker analysis included 225 patients and tested HRD status [N = 190; positive, N = 125 (65.8%)], PD-L1 expression [N = 196; positive, N = 56 (28.6%)], and BRCA1/2 mutation status (N = 219). The HRD-positive patients displayed greater median PFS than the HRD-negative patients [17.9 months (95% CI: 14.5-22.1) versus 9.2 months (95% CI: 7.5-13.8)]. PD-L1 was predominantly expressed on immune cells. Positive PD-L1 expression on immune cells was associated with shortened median PFS in the patients with germline BRCA1/2 mutations [14.5 months (95% CI: 7.4-18.2) versus 22.2 months (95% CI: 18.3-NA)]. Conversely, positive PD-L1 expression on immune cells wasassociated with prolonged median PFS in the patients with wild-type BRCA1/2 [20.9 months (95% CI: 13.9-NA) versus 8.3 months (95% CI: 6.7-13.8)]. HRD remained an effective biomarker for enhanced olaparib efficacy in the Asian patients with PSROC. Positive PD-L1 expression was associated with decreased olaparib efficacy in the patients with germline BRCA1/2 mutations but associated with improved olaparib efficacy in the patients with wild-type BRCA1/2. NCT03534453. Registered at May 23, 2018.

Accessibility of lung adenocarcinoma screening in the Chinese population: an exploratory analysis

Accessibility of lung adenocarcinoma screening in the Chinese population: an exploratory analysis

Longitudinal invariance of the Patient Health Questionnaire-9 among patients receiving pharmacotherapy for major depressive disorder: A secondary analysis of clinical trial data.

Comparing self-reported symptom scores across time requires longitudinal measurement invariance (LMI), a psychometric property that means the measure is functioning identically across all time points. Despite its prominence as a measure of depression symptom severity in both research and health care, LMI has yet to be firmly established for the Patient Health Questionnaire-9 depression module (PHQ-9), particularly over the course of antidepressant pharmacotherapy. Accordingly, the objective of this study was to assess for LMI of the PHQ-9 during pharmacotherapy for major depressive disorder. This was a secondary analysis of data collected during a randomized controlled trial. A total of 1,944 veterans began antidepressant monotherapy and completed the PHQ-9 six times over 24 weeks of treatment. LMI was assessed using a series of four confirmatory factor analysis models that included all six time points, with estimated parameters increasingly constrained across models to test for different aspects of invariance. Root-mean-square error of approximation of the chi-square difference test values below 0.06 indicated the presence of LMI. Exploratory LMI analyses were also performed for separate sex, age, and race subgroups. Root-mean-square error of approximation of the chi-square difference test showed minimal change in model fits during invariance testing (≤ 0.06 for all steps), supporting full LMI for the PHQ-9. LMI was also supported for all tested veteran subgroups. As such, PHQ-9 sum scores can be compared across extended pharmacotherapy treatment durations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

AntiMicro.ai: An Artificial Intelligence powered web application for predicting antibacterial/antifungal susceptibility and constructing personalized machine learning models

Background To train and develop machine learning models on the Pfizer antibacterial and antifungal datasets with subsequent deployment to an interactive Web Application. Methods We utilized R version 4.3.1 to perform descriptive analysis to obtain features/predictors. Python 3.10 libraries NumPy, Pandas, Scikit learn, Pycaret were used to train machine learning models. All these models were scored using area under the curve, recall, precision, F1, Kappa and the Mathews correlation coefficient. The best performing model was then deployed into a web application built on Streamlit after which deployment was done using GitHub and Streamlit cloud. A prototype android app was also developed using GoNative. Results The exploratory data analysis, S Aureus (17.2%) was the most common species however in the sub group analysis of the isolates with genotypic values, K Pneumoniae(48.2%) and E Coli (36.9%) were dominant. Amongst the fungi, Candida albicans (38.3%) and Candida glabrata (15.5%) were dominant. Feature selection was done using Shapley additive explanation plots. Using Extreme Gradient Boosting (XGBoost), we were able to achieve 99% and 97.8% AUC in the prediction of antibacterial and antifungal susceptibility respectively with minimal overfitting. Conclusions Decision tree based methods are a viable options of predicting antibacterial and antifungal drug resistance. When presented in visually appealing modes like web applications and android apps, it can be a useful guide to clinicians on initial treatment while awaiting definitive phenotypic testing. It can also be a surveillance tool that can craft antimicrobial resistance strategies.

Assistance in Preparing Simple Bookkeeping and MSME Taxation for the East Java Fatayat Business Group

The Pawon Urip Program in Lumajang Regency is community empowerment in terms of food security and community nutrition with the aim of empowering the socio-economic sector of the Pejarakan Village community. Physical observations, social observations, and interviews, as well as exploratory descriptive analysis, were used to answer the research objectives. The economy of the people of Pejarakan Village is classified as lower middle class; this, of course, cannot be separated from the influence of less than optimal levels of education and land use; the social phenomenon of apathy is also reflected when people are too busy. Pawon Urip planting actually provides benefits to the community; although insignificant, all the processes that go through until the results can be enjoyed have an impact on the knowledge, psychological, and economic aspects of the community. The managerial implication in this research is that with assistance, MSME owners will better understand the basics of accounting and taxation, which will help them prepare their books correctly. Good bookkeeping will also help increase financial transparency and may impact investor or lender confidence. With accurate financial data, MSME management can make better business decisions. Whether in terms of investment, expenses, or other business strategies.

Long term follow-up of patients with newly diagnosed glioblastoma treated by intraoperative photodynamic therapy: an update from the INDYGO trial (NCT03048240).

Glioblastoma remains incurable despite optimal multimodal management. The interim analysis of open label, single arm INDYGO pilot trial showed actuarial 12-months progression-free survival (PFS) of 60% (median 17.1months), actuarial 12-months overall survival (OS) of 80% (median 23.1months). We report updated, exploratory analyses of OS, PFS, and health-related quality of life (HRQOL) for patients receiving intraoperative photodynamic therapy (PDT) with 5-aminolevulinic acid hydrochloride (5-ALA HCl). Ten patients were included (May 2017 - April 2021) for standardized therapeutic approach including 5-ALA HCl fluorescence-guided surgery (FGS), followed by intraoperative PDT with a single 200J/cm2 dose of light. Postoperatively, patients received adjuvant therapy (Stupp protocol) then followed every 3months (clinical and cerebral MRI) and until disease progression and/or death. Procedure safety and toxicity occurring during the first four weeks after PDT were assessed. Data concerning relapse, HRQOL and survival were prospectively collected and analyzed. At the cut-off date (i.e., November 1st 2023), median follow-up was 23months (9,7-71,4). No unacceptable or unexpected toxicities and no treatment-related deaths occurred during the study. Kaplan-Meier estimated 23.4months median OS, actuarial 12-month PFS rate 60%, actuarial 12-month, 24-month, and 5-year OS rates 80%, 50% and 40%, respectively. Four patients were still alive (1 patient free of recurrence). At 5years-follow-up, intraoperative PDT with surgical maximal excision as initial therapy and standard adjuvant treatment suggests an increase of time to recurrence and overall survival in a high proportion of patients. Quality of life was maintained without any severe side effects. NCT03048240. EudraCT number: 2016-002706-39.

Targeted Analysis of Plasma Polar Metabolites in Postmenopausal Depression.

Depression will be the disease with the highest incidence worldwide by 2030. Data indicate that postmenopausal women have a higher incidence of mood disorders, and this high vulnerability seems to be related to hormonal changes and weight gain. Although research evaluating the profile of metabolites in mood disorders is advancing, further research, maintaining consistent methodology, is necessary to reach a consensus. Therefore, the objective of the present study was to carry out an exploratory analysis of the plasma polar metabolites of pre- and postmenopausal women to explore whether the profile is affected by depression. The plasma analysis of 50 polar metabolites was carried out in a total of 67 postmenopausal women, aged between 50 and 65 years, either without depression (n = 25) or with depression symptoms (n = 42), which had spontaneous onset of menopause and were not in use of hormone replacement therapy, insulin, or antidepressants; and in 42 healthy premenopausal women (21 without depression and 21 with depression symptoms), aged between 40 and 50 years and who were not in use of contraceptives, insulin, or antidepressants. Ten metabolites were significantly affected by depression symptoms postmenopause, including adenosine (FDR = 3.778 × 10-14), guanosine (FDR = 3.001 × 10-14), proline (FDR = 1.430 × 10-6), citrulline (FDR = 0.0001), lysine (FDR = 0.0004), and carnitine (FDR = 0.0331), which were down-regulated, and dimethylglycine (FDR = 0.0022), glutathione (FDR = 0.0048), creatine (FDR = 0.0286), and methionine (FDR = 0.0484) that were up-regulated. In premenopausal women with depression, oxidized glutathione (FDR = 0.0137) was down-regulated, and dimethylglycine (FDR = 0.0406) and 4-hydroxyproline (FDR = 0.0433) were up-regulated. The present study provided new data concerning the consequences of depression on plasma polar metabolites before and after the establishment of menopause. The results demonstrated that the postmenopausal condition presented more alterations than the premenopausal period and may indicate future measures to treat the disturbances involved in both menopause and depression.

How political and social constituent traits affect the responsiveness of legislators: A Comparative Field Experiment

AbstractA growing body of literature investigates whether legislators show biases in their constituency communication contingent upon constituent traits. However, we know little about whether and how findings of unequal responsiveness generalize across countries (beyond the United States) and across different traits. We address both issues using a pre‐registered comparative field experiment conducted in Germany, the United Kingdom and the Netherlands, in which fictitious citizens (varied by ethnicity, social class and partisan affiliation) inquired about legislators’ policy priorities regarding the COVID‐19 pandemic. Our pooled analysis reveals that co‐partisanship and class both increase the responsiveness of legislators while we find no effect for ethnicity. The effect sizes we find are small, but comparable to earlier studies and also noteworthy in view of our hard test design. Our exploratory analyses further corroborate the lack of discrimination against ethnic minority constituents in showing no intersectionality effects, that is, interactions between ethnic‐minority and low‐class identities. This exploratory step also addresses the country specific differences that we find. We speculate about plausible underlying party system effects that we, however, cannot substantiate due to statistical limitations. This important issue requires further attention in future research.

Data Science Methods for Real-World Evidence Generation in Real-World Data.

In the healthcare landscape, data science (DS) methods have emerged as indispensable tools to harness real-world data (RWD) from various data sources such as electronic health records, claim and registry data, and data gathered from digital health technologies. Real-world evidence (RWE) generated from RWD empowers researchers, clinicians, and policymakers with a more comprehensive understanding of real-world patient outcomes. Nevertheless, persistent challenges in RWD (e.g., messiness, voluminousness, heterogeneity, multimodality) and a growing awareness of the need for trustworthy and reliable RWE demand innovative, robust, and valid DS methods for analyzing RWD. In this article, I review some common current DS methods for extracting RWE and valuable insights from complex and diverse RWD. This article encompasses the entire RWE-generation pipeline, from study design with RWD to data preprocessing, exploratory analysis, methods for analyzing RWD, and trustworthiness and reliability guarantees, along with data ethics considerations and open-source tools. This review, tailored for an audience that may not be experts in DS, aspires to offer a systematic review of DS methods and assists readers in selecting suitable DS methods and enhancing the process of RWE generation for addressing their specific challenges.

Determinants of serious health outcome-free status in middle-aged and older people with dysglycaemia: Exploratory analysis of the ORIGIN trial.

To assess clinical and biochemical measurements that can identify people with dysglycaemia (i.e. diabetes or pre-diabetes) who remain free of serious outcomes during follow-up. We conducted exploratory analyses using data from the Outcomes Reduction with an Initial Glargine Intervention (ORIGIN) study to identify independent determinants of outcome-free status in 12 537 middle-aged and older adults with prediabetes and early type 2 diabetes from 40 countries. Serious outcome-free status was defined as the absence of major cardiovascular outcomes, kidney or retinal outcomes, peripheral artery disease, dementia, cancer, any hospitalization, or death during follow-up. In total, 3328 (26.6%) participants remained free of serious outcomes during a median follow-up of 6.2 years (IQR 5.8, 6.7). Independent clinical determinants of outcome-free status included younger age, female sex, non-White ethnicity, shorter diabetes duration, absence of previous cardiovascular disease, current or former smokers, higher grip strength, Mini-Mental State Examination score, and ankle-brachial index, lower body mass index and kidney disease index, and non-use of renin-angiotensin system drugs and beta-blockers. In a subset of 8401 people with baseline measurements of 238 biomarkers, growth differentiation factor 15, kidney injury molecule-1, N-terminal pro-brain natriuretic peptide, uromodulin, C-reactive protein, factor VII and ferritin were independent determinants. The combination of clinical determinants and biomarkers best identified participants who remained outcome-free (C-statistics 0.71, 95% confidence interval 0.70-0.73; net reclassification improvement 0.55, 95% confidence interval 0.48-0.58). A set of routinely measured clinical characteristics and seven protein biomarkers identify middle-aged and older people with prediabetes or early type 2 diabetes as least likely to experience serious outcomes during follow-up.

Nasal inhalation does not improve memory of visual repetitions.

Several studies suggest that breathing entrains neural oscillations and thereby improves visual detection and memory performance during nasal inhalation. However, the evidence for this association is mixed, with some studies finding no, minor, or opposite effects. Here, we tested whether nasal breathing phase influences memory of repeated images presented in a rapid serial visual presentation (RSVP) task. The RSVP task is ideal for studying the effects of respiratory-entrained oscillations on visual memory because it engages critical aspects of sensory encoding that depend on oscillatory activity, such as fast processing of natural images, repetition detection, memory encoding, and retrieval. It also enables the presentation of a large number of stimuli during each phase of the breathing cycle. In two separate experiments (n = 72 and n = 142, respectively) where participants were explicitly asked to breathe through their nose, we found that nasal breathing phase at target presentation did not significantly affect memory performance. An exploratory analysis in the first experiment suggested a potential benefit for targets appearing approximately 1 s after inhalation. However, this finding was not replicated in the pre-registered second experiment with a larger sample. Thus, in two large sample experiments, we found no measurable impact of breathing phase on memory performance in the RSVP task. These results suggest that the natural breathing cycle does not have a significant impact on memory for repeated images and raise doubts about the idea that visual memory is broadly affected by the breathing phase.

Bolstering the adaptive information processing model: a narrative review

In recent years, several theoretical models have been suggested as complementary to the adaptative information processing model of eye movement desensitization and reprocessing therapy. A narrative review of such models was conducted to assess the contributions of each, as well as their convergences, contradictions, and potential complementarity. Seven theoretical models were identified. All focus on the effects of EMDR therapy as a comprehensive psychotherapy approach with its principles, procedures, and protocols. Several refer to concepts related to propositional or predictive processing theories. Overall, the contribution of these proposals does appear to bolster Shapiro’s original AIP model, potentially offering additional depth and breadth to case conceptualization and treatment planning in clinical practice, as well as a more precise theoretical understanding. The current exploratory comparative analysis may serve as a preliminary baseline to guide research into the relative merit of suggested theoretical proposals to enhance current standards for the clinical practice and teaching of EMDR therapy.

Validation of the Mexican version of the EORTC QLQ-CR29 in patients with colorectal cancer.

The evaluation of the quality of life (QoL) of patients with colorectal cancer (CRC) is an essential measure to measure the impact of the disease and treatments on the lives of patients. However, in Latin America there is no validated and reliable instrument to assess this construct. This study aims to validate the EORTC QLQ-CR29 instrument in the Mexican population with CRC. This study aims to validate the EORTC QLQ-CR29 instrument in the Mexican population with CRC. The study used an instrumental design and a nonprobabilistic sample due to availability, made up of 251 patients with CRC, with an average age of 54.7 ± 12.28 years. Exploratory and confirmatory factor analyses were performed, as well as concurrent validity tests. The exploratory factorial analysis yielded 4 factors that explained 51.64% of the variance, with a Cronbach reliability coefficient of .766 and an Omega index of .725. The confirmatory factor analysis indicated that the proposed theoretical model fits the data almost perfectly, with an error close to 0, which shows that it is a balanced and parsimonious instrument to measure the QoL of the patients with CRC. The EORTC QLQ-CR29 instrument proved to be a valid and reliable instrument for use in clinical care and research directed at patients with CRC in Mexico. Its use is recommended by multidisciplinary health teams in oncology in Mexico, since it allows knowing the patient's perspective on the impact of CRC on their life, guiding therapeutic decision-making and being a primary outcome measure.

Quantifying direct and indirect effects of early‐season herbivory on reproduction across four brassicaceous plant species

Abstract Insect herbivores can directly affect plant reproduction by feeding on reproductive tissues, or indirectly by feeding on vegetative tissues for which plants are unable to compensate. Additionally, early arriving herbivores may have cascading effects on plant reproduction by altering the later arriving community. However, the dynamic interplay between plant development and the assembly of herbivore communities remains underexplored. Hence, it is unclear whether non‐outbreak levels of ambient herbivory early in the development of plants can impact plant fitness and to what extent these effects are mediated through changes in plant development and subsequent herbivory. By excluding the herbivore community in an exclosure experiment and by manipulating early‐season herbivory in a common garden field experiment replicated across four Brassicaceae species and 2 years, we tested whether early‐season herbivory by caterpillars (Pieris rapae) or aphids (Myzus persicae) affected development, reproduction, and the herbivore communities associated with individual plants. In addition, we tested a causal hypothesis to assess the relative importance and temporal interplay between variation in herbivore communities and variation in plant development in determining plant reproduction. Early‐season herbivory affected plant reproduction in the exclosure experiment, with effects being highly dependent on the plant species, the herbivore species and the year. However, we found no such effects in the field experiment. The exploratory path analysis indicated that variation in plant reproduction is best predicted by variation in plant development, explaining 80% of the total effect on seed production. This suggests early‐season herbivory had limited effects on later plant development, and plants were able to attenuate the impact of early‐season herbivory. However, no clear compensatory mechanism could be identified. While early‐season herbivory has the potential to affect plant reproduction through changes in plant development or the subsequent development of the associated community, these effects were small and varied across closely related species. This suggests that plant species may be exposed to different levels of natural selection by early‐season herbivores through plant‐ or community‐mediated effects on reproduction. Read the free Plain Language Summary for this article on the Journal blog.